title: Childhood-, teenage-, and adult-onset depression: diagnostic and individual characteristics in a clinical sample.
abstract: BACKGROUND
  The age at which a depressive episode is first experienced may be associated with particular individual and clinical characteristics. This study compares individual, clinical, and family characteristics across individuals who experienced their first major depressive episode when a child, teenager, or adult.
  
  
  METHODS
  Participants were 372 depressed outpatients who participated in 2 completed randomized trials for depression. The first compared fluoxetine and nortriptyline, whereas the second compared cognitive behavior therapy and interpersonal psychotherapy. Assessment across the studies included structured clinical interviews for Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I/II diagnoses and a range of self-report measures of symptoms, functioning, and childhood experiences.
  
  
  RESULTS
  Participants with childhood- and teenage-onset depression had a greater number of comorbid Axis I diagnoses, were more likely to meet criteria for Avoidant and Paranoid personality disorder (PD), and were more likely to have attempted suicide than those with adult-onset depression. Those with teenage-onset depression were more likely to meet criteria for a PD than those with adult-onset depression. Participants with childhood- and teenage-onset depression reported lower perceptions of paternal care before the age of 16 years, compared to participants with adult-onset depression.
  
  
  CONCLUSIONS
  Retrospective recall was used to classify individuals into childhood-, teenage-, and adult-onset groups and is subject to recall biases. The sample also consisted of treatment-seeking individuals.
  
  
  CONCLUSIONS
  There were relatively few differences between teenage and childhood depression. Depressive episodes that begin in childhood or teenage years are associated with more comorbid diagnoses, a higher likelihood of Avoidant and Paranoid PD, a greater likelihood of attempted suicide, and poorer perceptions of paternal care. Compared to adult-onset depression, childhood-onset depression is associated with greater comorbidity.
authors.affiliation: Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, New Zealand. kumari.fernando@otago.ac.nz
authors.forename: Kumari
authors.initials: K
authors.lastname: Fernando
authors.forename: Janet D
authors.initials: JD
authors.lastname: Carter
authors.forename: Christopher M A
authors.initials: CM
authors.lastname: Frampton
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Luty
authors.forename: Janice
authors.initials: J
authors.lastname: McKenzie
authors.forename: Roger T
authors.initials: RT
authors.lastname: Mulder
authors.forename: Peter R
authors.initials: PR
authors.lastname: Joyce
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D016009:Chi-Square Distribution; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D008297:Male; D011569:Psychiatric Status Rating Scales; D018709:Statistics, Nonparametric; D055815:Young Adult